midterm 1 Flashcards
1
Q
whats the point of reference in the sardas chart
A
patient
2
Q
3 things involved in rom active
A
voluntary, patient moves it, smaller then pasive
3
Q
key 4 of passive rom
A
in physiological barrier, involuntary, patient not move it, larger then arom
4
Q
joint play is in what barrier
A
in paraphysiological barrier and is a structural barrier
5
Q
where is jt play compared in arom and inactive
A
after active and inactive range
6
Q
where is adjustment made
A
jt play
7
Q
how many true jts are in the shoulder complex
A
3 gh, scj, acj
8
Q
what is the 4th shoulder jt not tru BIOMECAHNICAL jt
A
stj scapthoracic
9
Q
what makes a true jt
A
2 bones that come together and have articular surfaces wrapped by ligamentous structures filled with synovium
10
Q
how many biomechanical jts there are of shoulder
A
4
11
Q
whats the only real link to the axial skeleton when it comes to shoulder
A
scj
12
Q
if scj moves what else moves
A
acj and stj
13
Q
what are the components of the scj
A
synovial capsule, disk (under clav and above manubrium and cost cart)
14
Q
scj () more sub or dis
A
subluxates
15
Q
what direction does the scj sublux and why
A
anterior and superior because of a back sided facet prevent it go posterior and superior cause of pull from trap, lev scap, torque from scalenes
16
Q
what is lod for sc subluxation
A
posterior inferior
17
Q
what % of scj is dislocation
A
<1
18
Q
acj has a disc t or f
A
true
19
Q
with ue usage disk goes from fibrocartilage to
A
meniscoid
20
Q
what happens with disc in ue jt
A
it tins out and becomes softer and more pliable with less strength
21
Q
what hurts moer disclocation or sub of scj
A
subluxation
22
Q
whats hurts worse, fx clavicale of shoulder separation
A
shoulder separation
23
Q
what tears with sholder separation
A
anterior capsule, ac lig, cc lig
24
Q
what do you do with an acute shoulder separatoin
A
SAT, adj, taping, rice surger
25
what do u do with chronic acj shoulder separation
sct
26
where does the stj sit when sitting
siting; t2 (superior angle)
spine; t3
inferior; t7
27
where does the stj sit when laying down
sup ang; t1
spine; t2
inferior; t6
28
how far does the scap border sit from the sps
2 in
29
how many degrees of movement does the stj have
1 degree (elevation and epressioN) and 2 degree (protraction/retraction) and (upward rotation and downward rotation)
30
whats the primary movement of stj
elevation and depression
31
what is protraction
abduction and wraps around the person
32
what is retraction
adduction and brings to the spine
33
when looking at rotation what is point of reference
the inferior angle
34
inferior ang of scap goes towards arm is what movemetn
upward/lateral rotation
35
inf angle to spine its what move
downward/ med rotation
36
can u do rotation as a isolated movement of scap
no
37
adhesive capsulitis aka
frozen shoulder
38
how musch motion lose with capsulitis
1:1, every 1 dgree of gh movement u get 1 degree of movment in scapthor jt
get reduction of abduction
39
whats the normal motion of movement in sct jt and gh
2:1 2 gh 1 sct
40
what movement causes pain with adhesive capsulitis frozen shoulder
abduction
41
what can cause adhes capsulitis
trauma/direct/ indirect/ prolonged over use
42
what to do with acute acpsuilitis
sat, no rest keep moving
43
what to do with chronics capsulitis
sct, usd, heaters, massage
44
what is scap winging and what muscles involved
not good laydown of scap on back,
serratus anterior, subscapularis, rhomboid maj, min
45
what is codman's exercise for
adhesive capsulitis
stretches casule but no muscle usage: dead weight and move weight in circular motion with whole body
46
what makes gh not stable
large art surface of humerus and small art suface of scap
47
whats degree # angle of inclination of gh
130-150
48
what is the angle of inclination mean
between humeral head and shaft, midline of both
49
whats the # for angle of torsion of gh
30
50
what is the angle of torsion of gh
the angle in resting postion
51
what is the glenoidal labrum
extension of glenoid fossa
52
what doe the glendoidal labrun deepen and allow
it deeps and gives more articulation for the humerus nad allows long ehad of biceps to attach
53
the glenoidal labrum is () on top and () on bottom
loose on top and tight on bottom so don't dislocate
54
the glenohumeral capsul is () on top and () on bottom
tight on top and loose on bottom
55
what is the gh capsule supported by
subscapularis
56
what makes the cuff in sits
the capsule gh
57
if have issue with subscap it could cause
capsulitis
58
what make up the coracoacromial arch
coracoid process, acromion, coracoacromial lig
59
what structure if got injured swell or tear can take off 1/3 of protection of gh
coracromial lig
60
what does the coracromial arch protect and do
subacromial bursa, rotator cuff tendons (SSp), long head of BB
and keeps humerus form dislocating SUPERIOR
61
whats the most common sits muscle to be injured
supraspinaturs
62
shoulder saparation involves what jt
ac
63
shoulder dislocation inlves what jt
gh jt
64
what is the usal way of humerus dislocates
anterior and inferior
65
where are the bursae in upper e
subacromial and subdeltoid
66
which bursa usually doesn't too affected
subdeltoid
67
what is action of busae
referees and decresses friction
68
what position does the gh dislocate
hyperextension and er (this makes gh shoved anterior and shoulder blades stay behind)
69
what are the tests associated with dislocation
drawer, apprehension, dugas, feagin (inferior drawer)
70
what is the premium test for gh dislocation
dugas (touch opposite shoulder nad cant lower elbow)
71
whats the first thing to do when think dislocated shoulder
xray to rule out fx
72
acute tx of dislocation
rice, anesthetic relocation or kocher maneuver
73
what is the kocher maneuver
relocation procedure: pull it down, ext rot, abd, add to body, it lifts and I interally rotate
74
what time frame do u hae to do the kocher maneuver
3-4hrs
75
once do the kocher maneuver then do what
check radial, ulnar pulse, if its pale, cold, cyanotic, not strong send to e.r
could block axillary a.
76
chronic tx of dislocation
sct, emns, isometrics, isokinetics, isotonics
77
what are the 4 cardinal signs of inflammation
dalor: pain
rubor: redness
calor: heat
tumor: swelling
78
where get bursitis usually
subacromial bursa, inf to ac, sup to ss tendon
79
what movemtns cause pain with bursitis and what kind of rom
flex, abd, er,
both active and passive
80
what is soft tissue
muscle tendon fascia
81
what is hard tissue
bone ligament jt
82
if I passively move something and it hurts what kind of tissue is involved
hard tissue
83
burisitis even tho its a soft tissue it acts like a
hard tissue
84
what causes dislocation
trauma
85
what causes burisiti
trauma and overuse
86
what tests used for bursitis
push-button, dawbarns
87
what is dawbarns test
u push under acromion and have them abduct arm and pain goe away cause biceps and supraspinates get in way of push
88
acut tx of bursitis
sat rice
89
chornic tx bursitis
sct, mt heaters
90
rom of shoulder complex flexion and muscles involved
160, ant delt, long biceps, pec major
91
rom exetension shoulder and muscles
60 post delt, teres maj, min, lat dorse, triceps
92
rom adduction shoulder and muscles
75 pec maj, lat dorsi, teres maj
93
rom abd shoulder and muscles
180, supraspinatus, and middle deltoid
94
what movement needed to get full abdu of shoulder
er and inferior sliding of humerus
95
supraspinatus does how much degress of movement for first abduction
15
96
protraction rom scap
20
97
retraction rom scap
30
98
ir rom gh and muscles
70 subscapularis and pec major
99
er rom gh and muscles
100 infraspinatus and teres minor
100
what syndroms are involved with tos
scalenus anticus/anterior, cervical rib, costoclavicular, pect minor/hyperabduction
101
what structures included with tos
subclavian vein and artery, brachial plexus
102
what muscles could be involved with costoclavicular syndrome
lev scap, platysma, midd scalenes
103
besides syndromes what else can cause tos
neurovascular bundle compression, muscle spasm poor posture, trauma
104
with tos where would the subclavian artery be trapped
ccs at the clavicle (costoclavicular syndrome)
105
pec minor syndrome traps what pms
axillary artery at coracoid process
106
what does scalene sas anterior syndrome cause
anterior head carriage
107
what nerve get neuropathy with tos
ulnar
108
what tests for tos
adson (bring arm away extend head turned and feel pulse go away), for SAS
wright (abduct arm) for PMS
costoclavicular: bring arm forward and jam finger in there for CCS
109
tx tos
adjust, sat, sct,surgery (crs)
110
at rest the gh is stabilized by what
joint capsule, superior gh lig, ch lig
negative jt pressure
glenoid inclination
111
at weight bearing the gh stabilized by what
above supraspinatus ssp lig, and long head of bb
112
rom of elbow flexion and muscles
140 brachialis, biceps brachii, brachioradialis
113
wha muscle is ripped with avulsed biceps brachii
long head
114
how get avulsed biceps
lifting trauma, degeneration,
115
can they lift if avuls biceps
yes cause compensate with other msucles, brachialis
116
extension rom elbow and muslces
.3 (more women) triceps , anconeus
117
olecranon bursitis aka
students elbow
118
how get olecranon bursitis
trauma, inferiction, leaning on lebow alot
119
rom supination elbow muscles
80 supinator, biceps brachii, brachioradialis,
120
with supination there is more axial force load on what bone
ulnar
121
radial neuropathy aka
snp, Saturday night paulsy
122
how get snp
head bend down, arms abducted and extended
or trauma at mid humerus fx,
123
what are the ways to piss off a nerve
wollerian degeneration by compreesoin (like step on it)
cut the nerve
strectch the nerve which causes compression
124
sign of snp
wrist drop,
125
rom elbow pronation muscles
75 pronator teres, pronator quadratus, brachioradialis,
126
with pronation where is more axial force load on bone
radius
127
what muscle does the radial nerve split
the supinator
128
what causes ulnar neuropathy
trauma or foosh
129
where is the ulnar nerve
under pronator teres, through flex carpi ulnaris
130
ulnar neuropathy aka
pronator teres syndrome
131
test for ulnar neuropathy
+ wartenberg (spread fingers apart, bring together and pinky doesn't move), +froment(put paper between index and thumb and cant hold it if pulled out) , +tinel (tap on nerve)
132
what jt look at for carrying angle and what bone specifically
humero-ulnar jt and trochlea
133
what is the carrying angle in men
15
134
if fx troclea and get a varus position what is this called
gunstock deformity
135
why do women have a biiger carrying angle
cause forarm bones are shorter then males on average
longer trocleas, larger suface areas (superior to inferior length specifically)
136
carrying angle is valgus or varus
valgus
137
what bone is involved for the humeroradial jt
radial head
138
what bones involved for the radio ulnar artciulation
pivoting of radius around ulna
139
the common jt capsule of elbow blends in what what ligs
annular lig, mcl,lcl
encases jt on all sides
140
sales sign/fat pad sign is what
see in xray to see if common jt capsule is inflammed
141
what are 3 parts of mcl
anterior , posterior, transverse
142
what is function of mcl
stabilize valgus stress
limit end range extension
resist traction loads
143
medial epicondylitis aka
little league elbow, golfers ebow
144
medial and lat epicondilitis is what with what
tendonopathy with inflammation
145
tests for medial epicondylitis
tinels on ulnar +rev Mills (flex wrist and pronate against resistance)
146
after effects of med epicond
wrist flex weakness
147
causes of med epicond
repetitive wrist flex and pronations, microtears in soft tissue
148
3 parts of lcl
radial, ulnar, annular
149
function of lcl
stabilize varus, suprination stress, resists traction loads, stabilizes radial head
150
lateral epicondylitis aka
tennis elbow (when they hit back handed)
151
tests for lateral epicondylitis
+cozen (fist, wrist extend, doc tries to force into flex), +mills (flex wrist fist, they try to supinate with resistance)
152
affect of lat epic
weak wrist ext
153
causes of lat epic
repetitive wrist extension and suppinations, microtears in soft tissue
154
annular lig joins what
ulnar around radius back to ulna
155
annular lig is #/# of ring
4/5
156
what does annular lig part of what groups
capsule and lcl
157
al tear aka
nursemaids elbow, mall elbow, babysiiterr elbow
158
al tears happen with the swing which includes what 3 movements
pronation, extension, distraction
159
what elbow usually get al tear
left elbow cause most peeps are right handed when hold hand
160
what is functional paralysis that comes with nursemaid
choose not to move it but they can if they haveto
161
what is the al tear/ nursemaids elbow specificcaly (type of injury)
annular lig entrapment with radial head subluxation
162
rom flexion wrist muscles
75 flexor carpi ulnaris, flexor carpi radialis
163
rom extension wrist muscles
74 extensor carpi radialis longus/brevis, extensor carpi ulnaris
164
there is no musclular forces on what row of carpals
proximal row (intercalated)
165
intercalated makes the wrist () but is good for ()
unstable, good fro movement
166
under compression what carpal flexes and what carpal extends to dissipate stress
scaphoid flexes, lunate extends
167
DISI means
dosal intercalated segmental instability
168
what Is disi
where scaphoid lunate ligament allows for a lot of movement cause it snapped
169
what is the keystone for pivot bone
capitate
170
slac injury means
scapho lunate advanced collapse
171
what happens in slac injury
capitate falls and splits between scaphoid and lunate and can slide into the radius
172
how do you know if they have a slac injury
cant flex wrist to 75 degrees
173
in neutral the () and () are packed together
capititate and scaphoid
174
in full extension the () and () pack
scaphoid and lunate
175
what have adjusting apllications
the scaphoid being packed with lunate and capitate
176
how many tunnels are in the wrsit
6
177
capral tunnel syndrome involves what bones and nerve
pisiform, hamate hook to navicular/trapezium tunne;
median nerve
178
pisiform/hamate tunnel aka
tunnel of guyon
179
what boens and nerve involved with tunnel of guyon
hamate pisiform tunnel and ulnar nerve
180
what is the normal pressure on the median nerve
8 mml merv
181
what is the pressure if cyst on median nerve
32 mml merc!
182
what couldbe the etiology of carpal tunnel syndrom
compression of tunnel
direct trauma with swelling
lunate/capitate fx/subluxation
sol
183
what tests for carpal tunnel
```
esthetic sensations
tinels (tap on nerve0
phalens (back of hands together push on median nerve)
reverse phalen (prayer)
carpal compression
```
184
what is associated with the tunnel of guyon (symptoms)
ulnar triad
185
what is the ulnar triad
tenderness, clawing, hypothenar atrophy
186
tx of tunnel issues
```
rule out fx
de-inflame
adjust
elevation
tape styloid process/retinaculum
```
187
rom unlar deviation/adduction and muscles
35 flexor carpi ulnaris
| extensor carpi ulnaris
188
rom radial deviation and muscles
21 extensor carpi rad longus
| abductor pollicis longus and extensor pollicis brevis
189
biomechanics of carpals has ()
reciprocal motion
190
if prozimal row goes right ethe distal row goes
left
191
whats importance of reciprocal motion
increases range of motion of wrist
| keeps ligaments from overstretching on only one ligament
192
adjusting application of carpals (no deviation cause of)
lil to no deviation due to closed pack position in full extension
lil to no deviation due to splaying
193
de quervians disease is what
stenosing tenosynovitis (sheath closes on part of tendon (stenotic)
194
stenose means
constrict
195
patent means
open
196
what muscles involved with de quervians disease
abductor polllicis longs, extensor pollicis brevis
197
specifically de quervains disease has the inflamed tenon on what are
radial styloid process
198
etiology of de quervians
overuse trauma of thumb, wrist, direct trauma
199
presentation of de quervains disease
increased pain on thumb/wrist exetension
increased pain on general wrist flexion
tender on radial styloid process
200
what test for de quervanisn
+ finklesteins (tuck thumb in palm and then ulnar deviate)
201
tx of de quervains
adjust immobilize, surgery
| cortisone
202
dupuytrens contracture is what
nodule formation on hand flexor tendons/aponeurosis
203
what causes dupuytrens
unknown genetics
204
presentation of dupuytrens
flexion deformity of hand
fingers drawn into palm
pain may/may not present
205
tx of dupuytrens
ems (lvdc with iontophoresis;mg)
stretching
cortisone
surgery
